Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Daytime Phone
E-mail

Payment options:

            Visa    MasterCard    C.O.D.

  Credit Card Number (number only)

  Expiration Date  (numbers only in space) 

  3 Number Security Code (on back)               

  Name as it appears on Credit Card

Please provide the following ordering information:   (Please enter the weight of the seed in the same box as the description of the seed, i.e. 5 lb. Tendergreen Green Bean Seed)

QTY	DESCRIPTION

	SHIPPING ADDRESS (if different from above )
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country